U.S. patent number 4,250,873 [Application Number 05/897,060] was granted by the patent office on 1981-02-17 for endoscopes.
This patent grant is currently assigned to Richard Wolf GmbH. Invention is credited to Ludwig Bonnet.
United States Patent |
4,250,873 |
Bonnet |
February 17, 1981 |
Endoscopes
Abstract
This invention relates to endoscopes comprising for inserting an
implant liner into an opening through a stricture in the urethra.
According to the invention, the endoscope comprises the following
features: (a) an outer barrel, a tensioning tube displaceable
axially in the distal direction within said outer barrel against
resilient means with radial clearance, an external annular ridge
and longitudinal slots at the distal end of said tensioning tube
the sections of said tube situated between said slots being
arranged to spring radially inwards, (b) a holding tube which
extends through said tensioning tube to receive a telescope said
holding tube being fixed in relation to said outer barrel, and
having a distal portion of reduced diameter, and an annular ridge
adjacent its distal end, and (c) an implant liner which comprises a
distal bush and a proximal bush between which are bridges formed by
strips which are sprung to arch outwards, the inside diameter of
said distal bush being smaller than the external diameter of said
annular ridge on said distal section of reduced diameter of the
said holding tube, and the inside diameter of said proximal bush
being such that the bush can be inserted over said annularly ridge
of said tensioning tube when the latter is sprung inwards and its
outside diameter being such that it is carried in the barrel fitted
into the distal end thereof.
Inventors: |
Bonnet; Ludwig (Knittlingen,
DE) |
Assignee: |
Richard Wolf GmbH
(DE)
|
Family
ID: |
6678185 |
Appl.
No.: |
05/897,060 |
Filed: |
April 17, 1978 |
Foreign Application Priority Data
|
|
|
|
|
Apr 26, 1977 [DE] |
|
|
7713059[U] |
|
Current U.S.
Class: |
600/104;
600/127 |
Current CPC
Class: |
A61B
1/307 (20130101); A61M 29/02 (20130101); A61M
31/00 (20130101); A61F 2002/047 (20130101); A61F
2/9517 (20200501); A61F 2/962 (20130101) |
Current International
Class: |
A61F
2/06 (20060101); A61M 29/00 (20060101); A61M
31/00 (20060101); A61B 1/307 (20060101); A61B
001/00 () |
Field of
Search: |
;128/3-8,349R,35R,33R,305.3,330,DIG.25,341,344,345,325,303.11,303.15,33A |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Michell; Robert W.
Assistant Examiner: Tayon; Jeffrey W.
Attorney, Agent or Firm: Kinzer, Plyer, Dorn &
McEachran
Claims
I claim:
1. An endoscope for inserting an implant liner into an opening
through a stricture in the urethra, said endoscope comprising a
telescope for viewing internal anatomy and further comprising the
following:
(a) an outer barrel having a telescope eyepiece at the proximal end
thereof which is remote from the opposite or distal end, a
tensioning tube having both proximal and distal ends and being
displaceable axially in the distal direction within said outer
barrel and against a resilient means, said resilient means being
suspended from said outer barrel, and external annular ridge and
longitudinal slots at the distal end of said tensioning tube and
the sections of said tube situated between said slots being
arranged to spring radially inwards,
(b) a holding tube having a proximal end and a distal end, and said
holding tube having a proximal portion and a distal portion, and
which extends through said tensioning tube to receive the
telescope, and said holding tube being fixed in relation to said
outer barrel, said distal portion of said holding tube being of
reduced diameter, and there being an annular ridge adjacent the
distal end of said holding tube, and
(c) an implant liner which comprises a distal bushing and a
proximal bushing between which are resilient bridges formed by
strips which are sprung to arch outwards, the inside diameter of
said distal bushing being smaller than the external diameter of
said annular ridge on said distal portion of reduced diameter of
the said holding tube, and the inside diameter of said proximal
bushing being such that said proximal bushing can be inserted over
said annular ridge of said tensioning tube, and the outside
diameter of said proximal bushing being such that the proximal
bushing is carried in the barrel by being fitted into the distal
end thereof.
2. An endoscope according to claim 1, which further comprises
finger and thumb grips, a reinforcing tube receiving said
tensioning tube and a guide receiving said reinforcing tube, and
wherein said reinforcing tube is connected via a longitudinal slot
to said thumb grip which, in common with said tensioning tube, is
biased by a compression spring constituting said resilient
means.
3. An endoscope according to claim 2, wherein said reinforcing tube
has a distal end and, towards its distal end, a tubular shank
having an external thread with which is engageable a knurled nut
freely rotatable on said reinforcing tube with some axial play.
Description
BACKGROUND OF THE INVENTION
As men become older, the actual urethra often becomes smaller in
diameter and this may result in the retention of urine, thus
compelling the doctor responsible for treatment to slit the urethra
at the point where the constriction is situated, i.e. to perform
what is known as the opening of a stricture. Since the wound
contracts in the course of healing, there is a danger that the open
passage through the urethra which has been created will grow
together again or will become very much restricted.
To prevent the opening through the stricture growing together again
this way, it has already been suggested that an implant liner be
inserted in the opening through the stricture by means of an
endoscope. The implant liner remains in the opening until the wound
has healed and is then withdrawn again through the urethra from the
healed opening by means of the endoscope. In this known endoscope,
in addition to a telescope having a light conductor, there is also
a parallel tube extending through the barrel of the endoscope, for
a longitudinally displaceable shaft having forceps jaws at the
distal end which spread open resiliently and by means of which an
implant liner is gripped, inserted through the urethra and placed
in the opening through the stricture, where it is released by
moving the shaft of the forceps.
The liner advantageously consists of plastics material and it has
been found extremely difficult to insert it because the telescope
is situated alongside the guide for the forceps jaws, and also that
with this design the barrel of the endoscope is of undersirably
large diameter.
It is an object of the invention to enable a liner to be safely
inserted in an opening through a stricture which has previously
been made by slitting, while at all times under satisfactory
observation and using a barrel of reduced diameter.
SUMMARY OF THE INVENTION
To enable this and other objects to be achieved, the invention
provides an endoscope for introducing an implant liner into an
opening through a stricutre in the urethra which comprises the
following constituent parts:
(a) an outer barrel in which a tensioning tube is displaceable
axially in the distal direction against resilient means with radial
clearance, said tube being provided at the distal end with an
external annular ridge and longitudinal slots, the sections of the
tube situated between the slots being designed to spring radially
inwards,
(b) a holding tube which extends through the tensioning tube to
receive the telescope, which is fixed in relation to the barrel,
which has a distal portion of reduced diameter, and which has an
annular ridge adjacent its distal end,
(c) and an implant liner which comprises two bushings between which
are bridges formed by strips which are sprung to arch outwards, the
inside diameter of the bushings at the distal end being smaller
than the external diameter of the annular ridge on the distal
section of reduced diameter of the holding tube and the inside
diameter of the bush at the proximal end being such that the
bushing can be inserted over the annularly ridged end of the
tensioning tube when the latter is sprung inwards and its outside
diameter being such that is carried in the barrel, fitted into the
distal end thereof.
With this construction, the telescope and its light conductor
extend centrally through the holding tube, so that the liner can be
accurately inserted in the opening through the stricture while
under proper observation, using an endoscope which is of
comparatively small diameter as a result of the holding tube being
mounted in the tensioning tube and the tensioning tube in the
barrel the implant liner projecting only slightly or not at all
beyond the diameter of the barrel when inserted through the urethra
but being able to open out in the opening through the stricture, as
will be described in detail below.
BRIEF DESCRIPTION OF THE DRAWINGS
In order that the invention may be more clearly understood
reference will now be made to the accompanying drawings, which show
one embodiment thereof by way of example, and in which:
FIG. 1 is a side-view of an endoscope for inserting an implant
liner in an opening through a stricture in the urethra,
FIG. 2 is a similar side-view, partly in section, showing the
implant liner fitted on the distal end of the endoscope,
FIG. 3 shows the distal end of the endoscope in the appropriate
position for insertion in the implant liner, and
FIG. 4 is a side-view of the implant liner.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring now to the drawings, these show an endoscope for use in
the urethra, which comprises a barrel 1 (indicated in chain lines)
having a proximal machined part 2, and a unit 3 which can be locked
to the barrel by a bayonet coupling using a taper 4, a pin 5 and a
handle 6, or in other way found suitable. On the machined part 2,
the barrel 1 has opposing cocks for the inflow and outflow of
irrigating water.
The unit 3 comprises a tapered part 7 having two opposing finger
grips 8 and 9 and contains two opposing apertures 10 and 11 lying
at 90.degree. to the finger girps 8, 9. Through the tapered part 7
extends a tensioning tube 12 having a distal annular ridge 13. At
the distal end the tensioning tube is provided with for example
four longitudinal slots 14 uniformly distributed around its
circumference, and the sections of tube between the slots are
designed to spring radially inwards. Proximally, a reinforcing tube
15 is soldered onto the tensioning tube 12 and towards the distal
end is it formed as a tubular threaded shank 16. At the proximal
end, the reinforcing tube 15 is provided with a fixed arm 17 to
which a finger loop 19 is connected via a shank 18. The shank 18
may be rotatably secured to the arm 17 for comfort in use.
Extending co-axially through the tensioning tube 12 is a holding
tube 20 which is of somewhat reduced diameter along a distal
section 21 and which has an annular ridge 22 adjacent its distal
end. Proximally, the holding tube 20 is permanently connected via a
guide tube 23 to a terminal part 24 having an internal taper and in
the distal direction it passes through the turned part 7. Between
the distal end of the guide tube 23 and the tubular threaded shank
16, which advantageously has a multiple-start external thread, a
freely rotatable knurled nut 29 is mounted on the reinforcing tube
15. This nut can be turned through the two lateral apertures 10, 11
and can be engaged with the external thread on the tubular shank
16, as will be explained below. Connected to the terminal part 24
is a bayonet collar 25 having a handle 26, to allow the telescope
33, which has an eye-piece 34 and a lateral connector 25 for a
light conductor to be coupled on. In the rest position shown in
FIG. 1, the telescope 33 projects slightly from the distal end of
the holding tube 20. The arm 17 connected to the reinforcing tube
15 is connected to the finger grip 8 by a compression spring, e.g.
a leaf spring 31, and projects through a longitudinal slot 28 in
the guide tube 23. The compression spring 31 forces the reinforcing
tube 15 and thus the tensioning tube 12 to an extreme proximal
position which is defined in practice by the knurled nut 29, which
in the rest position presses against the distal end of the guide
tube 23 on one side and the threaded shank 16 on the other.
The implant liner 36 which is used is shown in FIGS. 2 and 4 and
comprises two bushings 38 and 39, between which are narrow strips
37 of resilient material which form bridges and which arch outwards
to form a sort of cage in the rest position. The narrow strips 37
and the bushings 38 and 39 are coated with a physiologically
acceptable plastics material. Of the two bushings, which are of the
same outside diameter, the bush 39 at the distal end has an inside
diameter which is somewhat smaller than the diameter of the annular
ridge 22, while the inside diameter of the bushings 38 is such as
to allow the ridge 13 on the tensioning tube 12 to slide through it
when the end of the tensioning tube 12 which is provided with the
slots 14 is situated in the region of the smaller diameter 21 of
the inner holding tube 20.
The way in which operations take place with the endoscope described
above is as follows: Beginning from the state shown in FIG. 1, the
tensioning tube 12, which carries the reinforcing tube 15, is moved
in the distal direction in relation to the holding tube 20 out of
the barrel 1 in opposition to the resilient means 31, by pressure
from fingers and thumb against the finger grips 8, 9 and 19, until
the annular ridge 13 and the sections located between the slots 14
are in the region where the thinner end 21 of the holding tube 20
is situated. Hence, the sections between the slots 14 spring
radially inwards, with the result that the diameter of the annular
ridge 13 is reduced somewhat, as shown in FIG. 3. With the
endoscope in this position the implant liner 36 is inserted on the
distal end of the tubes 20 and 12 until the ridge 22 on the inner
holding tube 20 rests against the proximal end of the bush 39,
while the ridge 13 slides through the bush 38 and as it does so the
liner 36 is slid over the tensioning tube 12 and the bush 38
engages in the distal end of the barrel 1. The pressure from the
fingers against the grips 8, 9 and 19 is now relaxed and the spring
31 thus moves the tensioning tube 12 in the proximal direction, the
sections of tube between the slots 14 at the distal end being
forced outwards again by the thicker part of the holding tube 20
and the ridge 13 then applying itself to the inner distal end of
bush 38. In this way the implant liner 36 is firmly connected to
the distal end of the endoscope, but the strips 37 of the implant
liner are arched outwards and are thus of greater diameter than the
barrel 1. To reduce the strips 37 to the same or approximately the
same, diameter as the barrel 1, the knurled nut 29 is now engaged
with the thread on the tubular threaded shank 16 and is turned,
thus drawing the reinforcing tube 15 and the tensioning tube 12
somewhat further into the barrel 1 in the proximal direction, the
ridge 13 then carrying bush 38 with it while bush 39 is held
statinary by ridge 22. In this way, the strips 37 of the implant
liner 36 are straightened out to the same, or approximately the
same, diametric size as the barrel 1. The endoscope and the implant
liner are then pushed along the urethra to the opening through the
stricture and pressure from the fingers is then again exerted on
the grips 8, 9 and 19, in opposite to the spring 31, so that the
diameter of the annular ridge 13 on the tensioning tube 12 reduces
as shown in FIG. 3, whereby the distal end of the endoscope can be
withdrawn from the implant liner 36 and at the same time the whole
instrument can be withdrawn from the urethra. At the same time the
liner spreads open, as a result of the strips 37 arching outwards,
and enlarges the opening through the stricture accordingly. To
withdraw the implant liner once the wound formed by the opening
through the stricture has healed, the reverse procedure is
adopted.
* * * * *